Head ache - Causes & Solutions

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Headaches are extremely common - most people have a headache at some time in their life. Most headaches disappear on their own (with a little time) or with the help of mild pain relievers. Although most headaches are mild and temporary annoyances, some people have headaches that are so severe they need to consult a doctor for pain relief.

Children can also have headaches, some well before they reach the age of 10. Research shows that before puberty, headaches are more common in boys, but that trend is reversed after puberty. Adult women experience more headaches than adult men, and they're often linked to a woman's menstrual cycle. With advancing age, both women and men tend to have fewer, less severe headaches.

If you tend to have headaches that are frequent and severe, your doctor will examine you for any serious, life-threatening conditions (e.g., stroke, meningitis) and start emergency care if needed. As well, if you regularly have headaches and experience a change in the pattern of your usual headaches, you should see your doctor.

Typically, a thorough medical history and physical examination is enough for a good diagnosis. Since tension headaches are very common, your doctor will ask questions about your current stress level and other personal factors (e.g., work) that may be triggering your headaches. Depending on the location, duration, and any accompanying symptoms, the type of headache can be determined.
In some cases, a brain scan called a CAT (computer assisted tomography) scan or MRI (magnetic resonance imaging) may be used to check for serious causes of headache.

Since tension headaches are caused by factors such as neck strain, stress, and anxiety, treatment involves eliminating the stressful situation, if possible. Taking an over-the-counter pain reliever such as acetaminophen* or ibuprofen, and finding ways to relax, rest, correct poor posture, and exercise can all help to relieve and prevent headache pain.

Cluster headaches respond poorly to over-the-counter medications. Oxygen therapy and prescription medications such as lithium, calcium channel blockers (used also to treat high blood pressure), steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and some antimigraine medications, among others, can help in many cases. If you suspect that you have cluster headaches, you should check with your doctor.

Sinus headaches usually require antibiotics or other treatments to clear up the infection. Once the infection is gone, the headache will go away, too. Until the infection gets better, taking an over-the-counter pain reliever can help ease the pain.

Migraines can be treated with over-the-counter pain relievers, such as acetylsalicylic acid (ASA), acetaminophen, or ibuprofen, if the headaches are mild.

Stronger medications may need to be prescribed if the headaches are more severe. These can be divided into two groups:

Acute treatments:
  • pain relievers containing codeine or meperidine
  • NSAIDs
  • ergot derivatives (e.g., ergotamine)
  • serotonin agonists called "triptans" (e.g., sumatriptan, zolmitriptan)
  • dopamine antagonists (e.g., metoclopramide, prochlorperazine)
Preventive treatments:
  • antiseizure medications such as valproic acid, divalproex sodium, gabapentin, and topiramate
  • blood pressure medications such as beta-blockers (e.g., propranolol or metoprolol), candesartan, lisinopril, and calcium channel blockers (e.g., flunarizine and verapamil)
  • riboflavin (vitamin B2), coenzyme Q10, butterbur, or magnesium supplements
  • serotonin blockers such as pizotifen
  • tricyclic antidepressants such as amitriptyline and nortriptyline
  • avoiding headache triggers

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